PATU3 Autoantibodies in "seronegative" myasthenia gravis

W J Zhang
November 2010
Journal of Neurology, Neurosurgery & Psychiatry;Nov2010, Vol. 81 Issue 11, pe25
Academic Journal
Myasthenia Gravis (MG) is an autoimmune disease characterised by a defect in the transmission of nerve impulses to muscles. Patients with a diagnosis of MG may test negative for both acetylcholine receptor (AChR) and muscle specific kinase (MuSK) antibodies on conventional immunoprecipitation assays. These patients are often termed seronegative (SNMG). Recent studies using cell-based assays have demonstrated the presence of low affinity IgG antibodies, with complement activating abilities that bind preferentially to clustered AChRs or MuSK on transfected cell membranes. Our objectives were (1) to audit the investigation of suspected MG at Addenbrooke's hospital. (2) To identify SNMG patients and test for sera AChR and MuSK antibodies using cell-based assays. (3) To test for low affinity antibodies at different stages of disease. We identified seven SNMG patients, one positive for low affinity MuSK and one positive for low affinity AChR antibodies respectively. Another individual was positive for AChR antibodies by the cell-based assay from the first serum sample, whereas the conventional assay showed positivity only in the sample taken 8 months later. This study highlights the potential importance of cell based assays for diagnosis and management of MG. The detection of antibodies in early stages of disease suggests the initial autoimmune response may be dominated by low affinity antibodies. AV and her department receive royalties and payments for antibody assays.


Related Articles

  • Anti-voltage-gated potassium channel Kv1.4 antibodies in myasthenia gravis. Romi, Fredrik; Suzuki, Shigeaki; Suzuki, Norihiro; Petzold, Axel; Plant, Gordon; Gilhus, Nils // Journal of Neurology;Jul2012, Vol. 259 Issue 7, p1312 

    Myasthenia gravis (MG) is an autoimmune disease characterized by skeletal muscle weakness mainly caused by acetylcholine receptor antibodies. MG can be divided into generalized and ocular, and into early-onset (<50 years of age) and late-onset (≥50 years of age). Anti-Kv1.4 antibodies...

  • Both binding and blocking antibodies correlate with disease severity in myasthenia gravis. Kang, Sa-Yoon; Oh, Jung-Hwan; Song, Sook; Lee, Jung; Choi, Jay; Kang, Ji-Hoon // Neurological Sciences;Jul2015, Vol. 36 Issue 7, p1167 

    Myasthenia gravis (MG) is an autoimmune disease associated with antibodies directed to the postsynaptic muscle components of the neuromuscular junction. The heterogeneous nature of the acetylcholine receptor (AChR) antibody response had led to the categorization of AChR antibodies into 3 types:...

  • Analysis of Serum miRNA Profiles of Myasthenia Gravis Patients. Nogales-Gadea, Gisela; Ramos-Fransi, Alba; Suárez-Calvet, Xavier; Navas, Miquel; Rojas-García, Ricard; Mosquera, Jose Luis; Díaz-Manera, Jordi; Querol, Luis; Gallardo, Eduard; Illa, Isabel // PLoS ONE;Mar2014, Vol. 9 Issue 3, p1 

    Myasthenia gravis (MG) is an autoimmune disease characterized by the presence of autoantibodies, mainly against the acetylcholine receptor (AChR). The mechanisms triggering and maintaining this chronic disease are unknown. MiRNAs are regulatory molecules that play a key role in the immune system...

  • Adult celiac disease with acetylcholine receptor antibody positive myasthenia gravis. Freeman, Hugh J.; Gillett, Helen R.; Gillett, Peter M.; Oger, Joel; Tsianos, Epameinondas; Okazaki, Kazuichi // World Journal of Gastroenterology;10/14/2009, Vol. 15 Issue 38, p4741 

    Celiac disease has been associated with some autoimmune disorders. A 40-year-old competitive strongman with celiac disease responded to a gluten-free diet, but developed profound and generalized motor weakness with acetylcholine receptor antibody positive myasthenia gravis, a disorder reported...

  • Miyastenia Gravis'li Olguda Anestezi Yönetimi. Yeğenoğlu, Füsun; Esmaoğlu Çoruh, Aliye; Artış, Tarık; Bayram, Adnan // Erciyes Medical Journal / Erciyes Tip Dergisi;2010, Vol. 32 Issue 1, p49 

    Myasthenia Gravis is an autoimmune disorder in which the patients produce antibodies that attach the nicotinic acetylcholine receptors at the neuromuscular junction. The interactions between myorelaxants, anticholinesterases or the other drugs that are used in general anesthesia can cause...

  • Juvenile Myasthenia Gravis: Three Case Reports and a Literature Review. Gadient, Paul; Bolton, Jeffrey; Puri, Vinay // Journal of Child Neurology;May2009, Vol. 24 Issue 5, p584 

    Juvenile myasthenia gravis is a rare disorder acquired in childhood, representing 10% to 15% of all cases of myasthenia gravis. Like the adult form, it is generally characterized by an autoimmune attack on acetylcholine receptors at the neuromuscular junction. Most patients present with ptosis,...

  • Modulation of B Cell Regulatory Molecules CD22 and CD72 in Myasthenia Gravis and Multiple Sclerosis. Lu, Jiayin; Li, Jing; Zhu, Tai-qing; Zhang, Longbo; Wang, Yuzhong; Tian, Fa-fa; Yang, Huan // Inflammation;Jun2013, Vol. 36 Issue 3, p521 

    B cell activation mediated by cluster of differentiation (CD) molecules plays an important role in B cell-related autoimmune diseases. CD22 and CD72 have been demonstrated to act as B cell inhibitory receptors in many autoimmune diseases. Activated B cells are involved in the pathogenesis of...

  • Juvenile seropositive myasthenia gravis with anti-MuSK antibody after thymectomy. Kostera-Pruszczyk, Anna; Kwiecinski, Hubert // Journal of Neurology;Oct2009, Vol. 256 Issue 10, p1780 

    We report the case of a 17.5-year old girl with generalized myasthenia gravis (MG). When she was 13, she started to complain of episodic diplopia, ptosis and mild fatigability of upper and lower extremity muscles. She was diagnosed with MG 3 years later, after exacerbation of her limb muscle...

  • Clinical: Myasthenia gravis.  // GP: General Practitioner;6/24/2005, p55 

    The article focuses on myasthenia gravis (MG), an antibody-mediated autoimmune condition characterized by impaired signaling at the neuromuscular junction that results in fatiguable muscle weakness. About 80 per cent of patients with generalized MG and 50 per cent of patients with ocular MG have...


Read the Article


Sign out of this library

Other Topics